Increasing access to CBT for psychosis patients: a feasibility, randomised controlled trial evaluating brief, targeted CBT for distressing voices delivered by assistant psychologists (GiVE2)

Background: The National Institute for Health and Care Excellence (NICE) recommends that Cognitive Behaviour Therapy for psychosis (CBTp) is offered to all patients with a psychosis diagnosis. However, only a minority of psychosis patients in England and Wales are offered CBTp. This is attributable, in part, to the resource-intensive nature of CBTp. One response to this problem has been the development of CBTp in brief formats that are targeted at a single symptom and the mechanisms that maintain distress. We have developed a brief form of CBTp for distressing voices and reported preliminary evidence for its effectiveness when delivered by highly trained therapists (clinical psychologists). This study will investigate the delivery of this intervention by a cost-effective workforce of assistant psychologists following a brief training and evaluate the acceptability and feasibility of conducting a future, definitive, randomised controlled trial (RCT). Methods: This is a feasibility study for a pragmatic, three-arm, parallel-group, superiority 1:1:1 RCT comparing a Guided self-help CBT intervention for voices and treatment as usual (GiVE) to Supportive Counselling and treatment as usual (SC) to treatment as usual alone (TAU), recruiting across two sites, with blinded post-treatment and follow-up assessments. A process evaluation will quantitatively and qualitatively explore stakeholder experience. Discussion: Expected outcomes will include an assessment of the feasibility of conducting a definitive RCT, and data to inform the calculation of its sample size. If evidence from a subsequent, fully powered RCT suggests that GiVE is clinically and cost-effective when delivered by briefly trained assistant psychologists, CBTp offered in these less resource-intensive forms has the potential to generate benefits for individual patients (reduced distress, enhanced recovery and enhanced quality of life), service-level patient benefit (increased access to evidence-based psychological therapies) and economic benefits to the NHS (in terms of the reduced use of mental health inpatient services). Trial registration: Current Controlled Trials, ISRCTN registration number: 16166070. Registered on 5 February 2019

Science and EAL teachers’ perspectives and practices in building word knowledge in implementing the new Victorian EAL curriculum

The recent implementation of The Victorian Curriculum F-10: EAL requires content teachers who teach EAL students to be familiar with the revised EAL curriculum for the purposes of planning and developing approaches to assist learners’ development in English. In the literature and in curriculum frameworks, word knowledge is considered an important aspect of EAL students’ learning. However, little is known about what pedagogical practices teachers across the curriculum perceive as being important, and use, in developing EAL students’ vocabulary. In this study, we investigated linguistically responsive vocabulary teaching in a Year 7 science class. Our aim was to elucidate teachers’ perceptions and practices in teaching vocabulary in science. The qualitative case study drew on principles of linguistically responsive instruction (LRI), which refers to practices for meeting the needs of students in culturally and linguistically diverse classrooms. Analysis of interview and classroom data from an EAL teacher and a science teacher revealed a range of LRI practices for developing word knowledge based on understanding the distinction between conversational and academic language, language learning principles, responsive teacher talk, plurilingual awareness, and the importance of social interaction for learners. We offer recommendations for a whole school approach to LRI, adaptation to online LRI, and curriculum development

Semi-supervised learning approach for crack detection and identification in advanced gas-cooled reactor graphite bricks

One of the life-limiting components of an Advanced Gas cooled Reactor (AGR) is its graphite core. The bricks present in the core undergo radiolytic oxidation throughout their lifetime which causes graphite weight loss and irradiation which can result in some of the bricks developing cracks. Understanding the nature and extent of brick cracking within the core is key to ensuring continued and extended operation of the AGR fleet. A semi-supervised machine learning classification algorithm is proposed as a method for improving the detection of cracked graphite bricks, by combining the labels derived from infrequent, detailed inspections of the core, with unlabeled, more frequent monitoring measurements taken during refueling operations. Semi-supervised machine learning, which is an emerging field in nuclear power condition monitoring, is the combination of ideas from both supervised and unsupervised machine learning whereby the data that is used to train the algorithm is a combination of labeled and unlabeled data. This paper introduces the initial research that has been undertaken in creating a semi-supervised self-training algorithm to detect the presence of graphite brick cracks and then proceeds to show that there is an improvement in the classification of graphite bricks using a semi-supervised machine learning classifier compared to supervised machine learning classifiers. This improved classification performance is encouraging as it does not require time consuming and costly human analysis to obtain extra learning information from available data

Health Literacy Centered Interventions in Glaucoma Medication Adherence

The influence of a patient’s health literacy on his/her health has become a topic of increasing interest over the past decade. Many studies have examined the effect of health literacy on disease understanding and health outcomes in multiple chronic diseases. However, there is scarce literature exploring the role of health literacy in the field of ophthalmology, specifically glaucoma. This paper includes systematic review of the current literature examining the effect of provider communication interventions on the rate of glaucoma medication adherence in patients with low health literacy. Of 89 titles identified for review, 86 were excluded based on population, intervention, outcome, or study design. The three included studies were assessed for study design, potential for selection bias, measurement bias, and confounding. All three studies were assigned an overall quality rating of fair based on these criteria. Comparison of results was difficult due to varying definitions of compliance and the use of multifaceted educational programs. However, the overall conclusion is that multifaceted interventions with both educational and behavioral aspects can improve glaucoma medication adherence by 9 to 19 percent. While statistically significant, the clinical importance of this improvement is still unclear. Based on the above results, a preliminary qualitative study using focus groups was designed to explore provider communications with low health literacy African American patients with glaucoma. The goal of the study is to attempt to understand how African Americans perceive medical information related to their glaucoma care and to then use that information to develop a tool for improving provider patient communication about glaucoma.Master of Public Healt

Readiness, response, and recovery: The impacts of COVID-19 on education systems in Asia

This review provides insights into COVID-19 responses in educational systems in Asia, and to understand which policies and practices were already in place to contribute to system readiness and resilience. Although the evidence base remains scarce, reflecting on the different system and school-level responses in Asia provides opportunity to identify gaps in current policies and research, and consider new ways in which countries in Asia can strengthen their educational systems into the future. It considers what makes an education system resilient, and the importance of school level practices. It uses an analytical framework to review readiness, response and recovery, and concludes with a discussion of gaps in evidence in Asia

Cardiac magnetic resonance findings predict increased resource utilization in elective coronary artery bypass grafting

Morbidity following CABG (coronary artery bypass grafting) is difficult to predict and leads to increased healthcare costs. We hypothesized that pre-operative CMR (cardiac magnetic resonance) findings would predict resource utilization in elective CABG. Over a 12-month period, patients requiring elective CABG were invited to undergo CMR 1 day prior to CABG. Gadolinium-enhanced CMR was performed using a trueFISP inversion recovery sequence on a 1.5 tesla scanner (Sonata; Siemens). Clinical data were collected prospectively. Admission costs were quantified based on standardized actual cost/day. Admission cost greater than the median was defined as 'increased'. Of 458 elective CABG cases, 45 (10%) underwent pre-operative CMR. Pre-operative characteristics [mean (S.D.) age, 64 (9) years, mortality (1%) and median (interquartile range) admission duration, 7 (6–8) days] were similar in patients who did or did not undergo CMR. In the patients undergoing CMR, eight (18%) and 11 (24%) patients had reduced LV (left ventricular) systolic function by CMR [LVEF (LV ejection fraction) <55%] and echocardiography respectively. LE (late enhancement) with gadolinium was detected in 17 (38%) patients. The average cost/day was $2723. The median (interquartile range) admission cost was$19059 ($10891–157917). CMR LVEF {OR (odds ratio), 0.93 [95% CI (confidence interval), 0.87–0.99]; P=0.03} and SV (stroke volume) index [OR 1.07 (95% CI, 1.00–1.14); P=0.02] predicted increased admission cost. CMR LVEF (P=0.08) and EuroScore tended to predict actual admission cost (P=0.09), but SV by CMR (P=0.16) and LV function by echocardiography (P=0.95) did not. In conclusion, in this exploratory investigation, pre-operative CMR findings predicted admission duration and increased admission cost in elective CABG surgery. The cost-effectiveness of CMR in risk stratification in elective CABG surgery merits prospective assessment

Being and becoming global citizens: Measuring progress toward SDG 4.7. Phase I: Monitoring teacher and school readiness to enact global citizenship in the Asia-Pacific region

Substantive work has been undertaken to define and frame global citizenship education (GCED). Global citizenship and related terms are included in the curricula and policy statements of many diverse nations around the world (Parker & Fraillon, 2016; APCEIU, 2020b), however, the education sector often struggles to enact and monitor GCED in ways that reflect the changing conditions of students and schools. This study responds to an identified need for enhanced tools and resources for schools and systems to monitor and evaluate GCED, in accordance with United Nations (UN) Sustainable Development Goal (SDG) 4.7. This need is particularly pressing in the primary school sector, where little research has examined staff or student interpretations of GCED, and the Asia-Pacific (APAC) region, where despite significant interest, gaps in understanding and implementing GCED remain. This report presents a draft framework for monitoring effective GCED, which is relevant to systems, schools, and staff supporting upper primary school students. The framework has been developed from a review of existing instruments and research, including work undertaken to frame and assess global citizenship for the Southeast Asia Primary Learning Metrics (SEA-PLM). To develop this framework, we have also sought the input of GCED experts and teachers from the Republic of Korea, the Philippines and Australia to ensure relevance to these contexts. Accompanying the framework is a series of preliminary questions for systems, schools, and teachers designed to assist in exploring enabling conditions for the enactment of global citizenship, which is also underpinned by key findings and gaps from the literature. This study is co-funded by UNESCO’s Asia Pacific Centre for International Understanding (APCEIU) and the Global Education Monitoring (GEM) Centre – a long term partnership between ACER and the Australian Government’s Department of Foreign Affairs and Trade

Summary report. Being and becoming global citizens: Measuring progress toward SDG 4.7. Phase I: Monitoring teacher and school readiness to enact global citizenship in the Asia-Pacific region

The relationship between global citizenship and education quality was established almost a decade ago, when it was described as a target under United Nations Sustainable Development Goal (SDG) 4.7 – to ‘ensure all learners acquire knowledge and skills needed to promote sustainable development.’ Despite efforts to define and frame global citizenship education (GCED), systems continue to grapple with understanding, enacting, and measuring it in ways that reflect changing local and global conditions for students, teachers and schools. This study responds to an identified need for tools and resources for systems to enact, monitor and evaluate GCED, particularly in primary school in the Asia-Pacific region. Presented here is a draft framework for monitoring effective GCED, which is relevant to systems, schools, and staff supporting upper primary school students. This was developed through a review of existing instruments and literature, consultation with experts, and data collected through questionnaires and focus group workshops with teachers from Australia, South Korea, and the Philippines

Collaboration during a crisis - the Lighthouse Lab volunteers.

As a group of early-career researchers, we recount our experiences of volunteering at one of the national Lighthouse Labs based at the UK Biocentre in Milton Keynes. We worked together as part of a multidisciplinary team to support the large-scale processing of coronavirus disease 2019 (COVID-19) swabs from across the whole of the UK